Diphtheria

and the ova of Ankylostoma duodenale were demonstrated in the faeces of the men. The latter were also found in the excretal deposits within the mine and spread was facilitated by the damp on the ladders whereby excrement was readily transferred from one person to another. Other worms such as Triocephalus, Ascaris and Oxyuris were also discovered, and these infestations were believed to have been introduced to the mines by the men who had returned from the Rand and other places. So striking were these findings that they were published considerably in advance of the main report which concerned itself more with silicosis.5 By the installation of sanitary buckets below ground, and with the insistence that they be used by the miners, its spread was arrested. Silicosis has proved a greater problem. It is interesting to observe that while the measures recommended against hookworm were to convert wet mines into dry ones, those advocated against silicosis were opposite, for it was suggested that the dust should be laid low with a water jet even at an increased risk of hookworm which was regarded as the less serious evil. It is unfortunate that the decline in hookworm in Cornwall 'should have been associated with a decline in mining itself. Although the closure of the mines aided the extinction of hookworm that helminth was not responsible for the slump in the industry. Where there is wealth to be had there are always the men to obtain it whatever the hazards and risks of permanent ill health.

T H E medicament was applied to the lupus patches, which were situated on and about the nose, once daily for three days, without an anaesthetic. During the time the solution is being applied, no water should be allowed to touch the face.
A SHORT report of a case of lupus of the chin, in which the excessive sensibility and the rapid progress of the disease was successfully treated with ice, applied twice daily, two hours each time. Holger Mygind.

ROSS, MAXWELL.-A Larynx and Trachea from a case of Diphtheria.
Medico-Chintrgical Society of Edinburgh, Wednesday, June 5, 1889.
THIS specimen was shown at the above meeting. The patient was a girl, aged eighteen months, of a very strumous habit. As the stenosis rapidly increased it was resolved to perform intubation of the larynx. This was done by means of O'Dwyer's instruments, and the ease with which the operation was performed, and the instant relief given, contrasted favourably with the difficulties surrounding the operation of tracheotomy in children of that age. She wore the tube for sixteen hours, when a violent cough occurred, and it was expelled from the mouth. It was replaced within half-an-hour, but the relief was not so great as on the first occasion, and death occurred in about an hour. At the post-mortem examination the membrane was found to have extended down to the bronchi. Though the case ended fatally, the experience gained was favourable to the operation of intubation. There was no difficulty with the swallowing' of liquids ; brandy, water, and milk were taken with ease, and even greedily, by the child. Dr. O'Dwyer had pointed out that many of the difficulties in swallowing" were due to the condition of the epiglottis rather than the presence of the tube, and in this instance the epiglottis was unaffected. Malposition of the tube might, however, be a cause of difficulty, the apex of the triangular head being turned forward, so as to project against the epiglottis, instead ot resting between the arytenoid cartilages, as intended by O'Dwyer.
Maxwell Ross. AN annotation, in which it is affirmed that, " while it will not be denied " that diphtheria is a disease produced by a neglect of sanitary pre-'' cautions, there is good reason to suspect that it is not always, or indeed " often, produced by ill-laid drains or bad sanitary appliances within a " house. It spreads, probably, generally by infection, but there are clearly " other causes at work There is good reason to believe that the " accumulation of large masses of decomposing vegetable material in the " neighbourhood of houses, and the neglect to keep the damp walls and " corners of cellars and disused passages clean, may be in some way " responsible for the epidemics of diphtheria which are now so frequent " both in town and country."

IRVING, JOHN (Leytonstone
Hunter Mackenzie. DR. PALMER reported nineteen cases with five recoveries. They were all cases of true diphtheria, and operation was delayed in every case till the dyspnoea was extreme and death inevitable. In three cases the malignancy of the disease and sepsis forbade all hope, and intubation was for relief only of the dyspnoea. Three died of sepsis, two of heart failure, and nine of extension of membrane into the bronchi. Of these nine, five gave good promises of recovery for two days after the tube was inserted, the other four were of such malignancy that hope was not entertained. The sources of danger ascribed to intubation as compared with those in tracheotomy are entered upon. This article is well worth perusal ; it is well written and most instructive. George W. Major.

LANGLOIS. -Respiratory Variations in Inhalation of Oxygen in
Diphtheritics. So,: de. fiiol., March 30, 1889. T H E author has made children affected with divers manifestations of diphtheria inhale oxygen. In these subjects he has observed an increase in the number of respiratory movements during the inhalations, and a slight diminution of the dyspnoea. The acceleration of the respiratory rhythm is opposed to the general fact, that during inhalations of oxygen, the respirations are slowed. Under the influence of prolonged asphyxia, the entire organism, and the bulbar centres especially, is depressed, which causes a diminution in the respiratory impulses.
Joal. A PAPER read at the Annual Meeting of the British Medical Association, 1888. The author details some experiments and observations which he has made on the three-fold functions of the nose, of considerable physiological and clinical importance. For an account of these the reader is referred to the original paper, which will well repay perusal.

GRELLET.-Facts relative to the Longevity of the Bacillus of Klete
Hunter Mackenzie. THE author has observed a certain number of cases of this kind :-A young girl, eighteen years of age, was only cured of a blepharospasm rebellious to all other treatment, by the ablation of numerous small nasal polypi.

KERMET.-Pathological Opening of the Maxillary Sinus in a Syphilitic
A lady, twenty-five years of age, has a blepharospasm every time that she has an attack of acute coryza.
A man, thirty-five years of age, has been cured of an ophthalmic migraine by extirpation of a number of small polypi.
There also exists a true nasal asthenopia, which only yields to treatment of the pituitary membrane. It is distinguished from other asthenopias by the integrity of refraction, of the conjunctiva and the lachrymal THE author relates the case of a young girl, strumous in constitution, and affected with a greyish ulcer of the left cornea with hypopion. The lachrymal passage was normal. There was simple ozitna and marked atrophy of the turbinateds. The ulcer had been treated in various ways without success. The ozrcna was treated, the nose being disinfected with